Swelling or fullness at the hernia site. Reported aching sensation (radiates into the area of the hernia). No true pain or tenderness upon examination. Masses that engorge with increasing intra-abdominal pressure and/or standing.
-Painful enlargement of a previous hernia or defect
-Cannot be manipulated (either spontaneously or manually) through the fascial defect
-Nausea, vomiting, and symptoms of bowel obstruction (possible)
Patients should be counseled to avoid increase intra-abdominal pressure activities like straining at defecation and lifting heavy objects!
This may require restrictions on work or school-related activities, which should be clearly delineated.
Patients should also receive instruction regarding ways of applying support to the hernia. Numerous medical device companies have developed support items that can assist with this process.
Even with asymptomatic hernias, repair at an early stage (ie, before the hernia enlarges) is preferred.
Referral to a general surgeon in Atlanta for discussion of the available types of hernia repair is warranted; with the advent of new meshes and laparoscopic approaches, the range of repair options is now wider than ever.